The value of 1ean nystagmus and sitting to supine positioning nystagmus in the diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo
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摘要: 目的:探讨低头位诱发眼震(LN)及坐-卧位诱发眼震(SSPN)对水平半规管良性阵发性位置性眩晕(HSC-BPPV)定位诊断的价值。方法:对100例明确诊断的HSC-BPPV患者先后行LN及SSPN及滚转试验(SRT),记录眼震方向,判断患病侧别,进行耳石复位治疗。当LN及SSPN无法引出时,按SRT指示进行患侧复位,当SRT无法判断患病侧别时,按LN及SPPN指示患侧复位,并将LN、SPPN试验及SRT均可引出的管石症患者随机分为2组,一组按SRT结果进行复位治疗(A组),另一组按LN及SPPN指示患侧复位治疗(B组),计算所有患者LN及SPPN的引出率及诊断符合率,并于1d后随访评估短期疗效。结果:LN及SPPN总引出率为83.0%,其与SRT诊断符合率达90.1%,按LN及SPPN指示患侧进行复位与按SRT结果进行复位治疗的HSC-BPPV的疗效比较,差异无统计学意义(P>0.05)。结论:LN及SPPN不能单独应用于HSC-BPPV的定位诊断,需结合SRT,但当SRT定位困难时,其仍可作为辅助的诊断方法,当二者结果不一致时,需重复试验进行全面评估,避免漏诊和误诊。
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关键词:
- 低头位诱发眼震 /
- 坐-卧位诱发眼震 /
- 水平半规管 /
- 良性阵发性位置性眩晕 /
- 诊断
Abstract: Objective:To explore the value of 1ean nystagmus and sitting to supine positioning nystagmus in the diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo.Method:One hundred cases of patients with definitive diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo were tested by 1ean nystagmus and sitting to supine positioning nystagmus and supine roll test.The affected side was recorded according to the nystagmus direction.After diagnosis, they were treated with canalith repositioning procedure.The canalith repositioning procedure was made according to the supine roll test result when 1ean nystagmus and sitting to supine positioning nystagmuscannot be induced.Furthermore, the canalith repositioning procedure was made according to the 1ean nystagmus and sitting to supine positioning nystagmuswhenthe supine roll test cannot diagnose.The patients with canalolithiasis were randomly divided into two groups when both 1ean nystagmus and sitting to supine positioning nystagmusand the supine roll test can be induced.One group was treated with canalith repositioning procedure based on results of supine roll test and the other group was treated based on the results of 1ean nystagmus and sitting to supine positioning nystagmus.The detection rate and diagnostic coincidence rate of 1ean nystagmus and sitting to supine positioning nystagmus were calculated and the short-term outcome were evaluated one day after treatment.Result:The detection rate of 1ean nystagmus and sitting to supine positioning nystagmus was 83%and the coincidence rate with the roll test was 90.1%, respectively.There was no significant statistical difference between the treatment effect according to lean nystagmus and sitting to supine positioning nystagmus and supine roll test.Conclusion:Lean nystagmus and sitting to supine positioning nystagmus cannot be used alone in the diagnosis ofhorizontal semicircular canal benign paroxysmal positional vertigo.They need to be combined with supine roll test.However, when the supine roll test is difficult to demonstrate the affected side, it can be used as an auxiliary diagnostic method.When the results of 1ean nystagmus and sitting to supine positioning nystagmusand the supine roll test are inconsistent, repeat the test and conduct a comprehensive assessment to avoid missed diagnosis and misdiagnosis. -
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